Brian Salmon, Perfusion Assistant, Chicago
A little over five years ago, I was diagnosed with testicular cancer. Even with my insurance, it still took me years to pay off the thousands of dollars of out-of-pocket costs.

After three years of follow-up visits, my insurance company told me that they no longer considered my hospital a provider for their plans. I had developed a relationship with the doctors, nurses, and staff at the hospital. They had been there during some of the toughest times of my life.

When it comes to a person's well-being there isn't much of a choice. Who chooses not to seek treatment for cancer? When the doctor tells you to do something or you will die, who says, "Gee, that's a little more than I was hoping to spend today"? It isn't like choosing between Coke or Pepsi.

In certain ways the American health care system is absolutely amazing. We know how to remove a person’s diseased heart, replace it with the heart of a cadaver, and have the person live out the rest of their life. Realistically, next to no one in America will ever have to worry about diseases like tuberculosis or malaria.

On the other hand, the American healthcare system is by no means fair or egalitarian. It, like everything else in our capitalist society, favors the wealthy. There are people who will only go to the Mayo Clinic to see a doctor, even if that means traveling across the country, while there are people who decide not to have that chronic cough checked out because it would mean less food on the table for the kids. In that way the American healthcare system is really screwed up, and it is a really complicated problem. For starters, it isn't just the doctors, hospitals, and insurance companies, it is every social aspect of a person’s health. The rich can afford to eat better. They can afford the time it takes to get regular exercise. Most important, they can afford health care to be proactive and not just reactive. Does anyone really think that a single mother of four that has to work a couple of part time jobs to pay the bills can get to Bally's three times a week?

Evonne Hilton North Seattle“I’m frustrated by the healthcare system.” Five years ago, Hilton fell and severely injured her head. She was in a managed healthcare system. The doctors didn’t do a diagnostic scan; she was seen in the emergency room and discharged without further treatment. She found herself unable to do her job due to severe memory loss and inability to function. She tried for several years to do other jobs within the organization, but finally had to quit. “I lost everything. No one would hire me. I was on the street for years.” Medicaid kicked in last year; she now lives on social security disability in a Seattle Housing authority apartment. She is able to pick her doctor and hospital. She suffers chronic daily headaches, a sometimes severe and disabling condition which affects about 1 in 6 people in the U.S.

Linas Raslavicius, Software Consultant, Huntington Beach, California.Raslavicius worked for Rockwell International as a software engineer for 16 years. He left the company 13 years ago, in part due to suffering from chronic fatigue syndrome. When he became a software consultant, he was denied individual health insurance due to his high blood pressure and other pre-existing conditions. He was able to qualify for the California’s Major Risk Medical Insurance Program, a 36-month program that provides health insurance for Californians who can’t get individual insurance on their own because they are considered to be “high risk”. The state subsidizes a portion of the premiums.

His insurance costs went up when he turned 50. The costs also increased last year by more than 25% to $768 per month. As an independent contractor, he says he can’t afford it if insurance costs continue to climb at those rates.

“I left Rockwell in 1993, and insurance wasn’t a big issue then. If you worked at a large well-established company, it wasn’t a problem for you. Going solo as an independent contactor has been substantially more difficult.”

Dr. Deborah Richter, Primary Care Physician and Health Care Reform Activist, Montpelier, Vermont. Current Chair of Vermont Health Care for All.I practice in a rural clinic in Vermont where I see the problems in health care up close. One in ten Vermonters are uninsured and another one in seven are underinsured, which means they have to scrape around to pay the first $5,000 to $10,000 in medical bills. They often avoid coming to the doctor and I have seen even young people die of preventable diseases. As a physician, I find it impossible to witness such atrocities and not get involved in reforming health care. It is clear to me that the only answer is to tackle rising health care costs and the financing of health care services in a systematic way that answers to everyone, not just to some. Let’s face it, at some point, like every other nation in the world, we are going to have to view health care as a public good and publicly finance it, for everyone. To have a kind of Medicare for all.

Roy Farrell, MD. Medical Director of Hospitals, Group Health, Seattle. Past President of Physicians for Social Responsibility
We provide world-class healthcare to a certain segment of our population who has insurance and at the same time we make other people go through bankruptcy to get the care they need. What’s happening now is the uninsured are growing slowly; the underinsured are growing dramatically.

We need a rational way to allocate our limited health care resources. I was an emergency physician for 30 years. All the dysfunction of society and our irrational system shows up there. All we have as emergency physicians is the very expensive alternative to preventative care. It’s a tragedy that we can’t give access to a meaningful relationship with a good primary care physician.

Like Dr. Richter, Dr. Farrell favors a universal health care plan similar to Medicaid, although he envisions one that is carried out on a regional basis. He points to Oregon's recent plan for Medicaid enrollees, which was carried out using what he calls “a meaningful public involvement process.”

A commission of health care providers and consumers got together and listed a set of common primary and acute medical conditions and services and rank-ordered them based on what was most important to the health and well-being for the people of their region. Once they knew how much money they had in their budget to spend caring for those conditions, they could say, for example, “At condition 618 we exceed our budget, so we'll only be able to cover all of the above conditions,” getting what Dr. Farrell calls “the most bang for their limited health care dollars.”

A regional approach also looks at what resources are available, such as how many hospital beds, neonatal units, etc. there are. “It needs to be a manageable system that can maximally benefit the whole population of that region,” he says. “This requires some major structural changes of how medical care is financed.” Farrell advocates getting rid of employer-based health care, which he believes doesn't best serve the needs of our population.
He also thinks we have to dramatically restructure our health care delivery system as well. “I still think we want competing, different delivery systems, but carried out in a rational way so that patients can select which group and hospitals they want to go to.”

Anonymous - Health care financial manager, Chicago

I'm a financial manager in Chicago-area health care. My feelings toward the U.S. health care system are very mixed. On the one hand, it has provided me with a career that has benefited me personally. On the other hand, from a moral standpoint, I feel it has many severe flaws. The fact that there are so many people in this country that cannot afford decent healthcare, or have great difficulties in affording and obtaining crucial medications is a shame in a country so wealthy.

The huge profits made by pharmaceutical companies are obscene, and the insurance companies do business in a way that provides as many obstacles as possible to the patient and the provider. Their machinations to try to avoid paying legitimate claims often drive a wedge between the patient and the health care provider, who is jumping through hoops to get a claim paid. Insurance companies, in my opinion, are one of the lowest forms of "life" on this planet. Preying on the legitimate needs of people for coverage, frustrating providers in their labyrinth of regulations, and willing to deny coverage at the drop of a hat —they're vultures.

I can’t wait until the time where I'm able to find a rewarding, well-paying career as far away from health care as possible.

Jay Bhatt, President American Medical Students Association (AMSA)

We’ve inherited a medical system that’s broken and leaving people behind. Health care is more than just a political or ethical issue—it’s a social justice issue. The uninsured crisis is a national problem in need of a national solution. That solution, we believe, is a national health insurance system—publicly financed, privately delivered.

AMSA is the birthplace of medical student activism. We’re working to engage medical students in change and to help them become socially responsible physicians. Our campaigns are mobilizing the future doctors of the U.S. to partner with organizations, community groups, education, and people like those of Gesundheit to bring health care to all. AMSA sponsors National Pharm-free day. Thousands of doctors and medical students have signed a pledge to say “no” to pharmaceutical company promotions—to say “our critical judgment is not for sale.”

“If we can move away from the fragmented system we have toward getting basic health care coverage for everyone, we’ll save money and have a healthier society.

Write your member of Congress. Be a HealthCare Voter. Campaign. Demand that our leaders improve the health care system. This is a partnership, and we ALL need to work to keep affordable health care for all at the forefront of our nation’s dialogue.”

Some of AMSA’s Campaigns:

Healthcare for America Campaign: Health professional students - including students in medicine, public health, dentistry, and nursing - are ideal for voicing patient concerns and promoting solutions to address the worsening health care industry. The Health Care for America Campaign is a nationwide lobbying initiative where future health care professionals will advocate for the following strategic points:

Ensuring access to quality and affordable health care for all.

Eliminating health disparities.

Diversifying the health professional workforce.

Health professional students will partner with local community advocacy organizations, identify the most pressing health care issues in each state and conduct lobby visits during a designated week.

Healthcare Workers Campaign: AMSA is partnering with HealthGAP, Physicians for Human Rights (PHR), and other organizations to bring awareness around the need for community healthcare workers. Building this workforce would be beneficial to us here at home.

It is imperative that the U.S. leads this initiative to build a sustainable health workforce in the developing world. This initiative would train, retain, and support at least 250,000 community health care workers in sub-Saharan Africa via support from strengthened existing facilities, focusing on public-health sector facilities

Erin Walker, 25, Student Chicago
“I have a hole at the base of my spine and I have no health insurance. The condition is not life threatening, but it can be extremely painful. There is a surgery that would take care of this condition, but the procedure would cost thousands of dollars. The antibotics alone are astronomically priced. So, I am not dying, but I can't do things I'd like to do like running or horseback riding. And now that it is a preexisting condition, I doubt it will ever be covered. America lags behind in education, environmental issues and our own healthcare. Sometimes I wonder how much business we have "helping" other countries when we can't even help our own.

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